Are eating disorders choices? Do you choose to develop an eating disorder, or to continue to engage in your symptoms, or are eating disorders strictly diseases, without any decision involved?
I think most of us would agree that by the time someone is knee deep in her eating disorder, there isn't much choice involved. And yes, there are factors such as genetic influences, familial circumstances, and comorbidity with other psychological disorders (e.g., depression, anxiety, substance abuse), all of which make eating disorders appear to be a fait accompli.
Eating disorders are diseases, right? Why would anyone choose to develop a disease? No one is questioning someone's depression or schizophrenia, and certainly not her Parkinson's or cancer.
But, for many who suffer from eating disorders, there's a moment, early on, when we make a choice--a choice to restrict, to binge, to purge, because in the moment, these behaviors seem to be the best option available to us.
Maybe it's just semantics, as this choice is made without informed consent, without recognition of what will follow. For others, even if there is an understanding of consequences, we might make the same choice, anyway, not really thinking the consequences will apply to us. Does a choice count if you don't even know you're making a choice?
When recovery is on the table, and we continue to engage in symptoms, is this a choice, or are our eating disorders speaking for us? Do you choose to hold on to an eating disorder, or does the disorder hold on to you?